Predatory publishing and cybercrime targeting academics.

The purpose of this report is to inform and warn academics about practices used by cybercriminals who seek to profit from unwary scholars and undermine the industry of science. This report describes the signs, symptoms, characteristics, and consequences of predatory publishing and related forms of consumer fraud. Methods to curb these cybercrimes include educating scholars and students about tactics used by predatory publishers; institutional changes in how faculty are evaluated using publications; soliciting cooperation from the industries that support academic publishing and indexing to curb incorporation of illegitimate journals; and taking an offensive position by reporting these consumer fraud crimes to the authorities. Over and above the problem of publishing good science in fraudulent journals, disseminating and citing poor-quality research threaten the credibility of science and of nursing.

The effects of age, gender, hopelessness, and exposure to violence on sleep disorder symptoms and daytime sleepiness among adolescents in impoverished neighborhoods.

Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49% female, 93% African-American) to examine trajectories of sleep problems by age (10-18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49% female, 100% African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains.

Sleep disturbance and risk behaviors among inner-city African-American adolescents.

Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998-2005; N = 20,716; age range = 9.75-19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. Using a cross-lagged panel multivariate approach comparing reports for two sequential years and controlling for age/gender plus exposure to traumatic stress and violence, prior sleep disturbance was associated with carrying a knife/gun, brandishing a knife/gun, using a knife/gun, quick temperedness, warmth toward mother, worry, and belief in the neighborhood street code in the latter year. Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.

The future of cognitive remediation training in older adults.

With the growing population of older adults, nurses will need to address age-related cognitive declines. Evidence demonstrates that cognitive remediation training is effective in improving neuropsychological abilities in older adults, which can translate into improved functioning in instrumental activities of daily living. The future of cognitive remediation training will incorporate health promoting factors (e.g., sleep hygiene, physical exercise), which supports neuroplasticity and cognitive reserve. By approaching cognitive health holistically, the patient will be primed to receive the maximum benefit from cognitive remediation training. A model emphasizing this approach is provided as adidactic for nurses and other health professionals providing care to their older patients.

Sleepiness and health in midlife women: results of the National Sleep Foundation's 2007 Sleep in America poll.

The 2007 Sleep in America poll, a random-sample telephone survey, provided data for this study of sleep in community-dwelling women aged 40 to 60 years. The majority of the respondents were post- or perimenopausal, overweight, married or living with someone, and reported good health. A subsample (20%) reported sleepiness that consistently interfered with daily life; the sleepy subsample reported more symptoms of insomnia, restless legs syndrome, obstructive sleep apnea, depression and anxiety, as well as more problems with health-promoting behaviors, drowsy driving, job performance, household duties, and personal relationships. Hierarchical regression showed that sleepiness along with depressive symptoms, medical comorbidities, obesity, and lower education were associated with poor self-rated health, whereas menopause status (pre-, peri- or post-) was not. These results suggest that sleep disruptions and daytime sleepiness negatively affect the daily life of midlife women.

22q11 deletion syndrome: is that what they used to call . . . ?

PURPOSE: 22q11 deletion syndrome (22q11DS) is a very common, but commonly overlooked, disorder that has many variable features, such as serious heart defects, speech and articulation problems, immune compromise, learning problems, pervasive developmental disorders, and a late appearing phenotype of this condition--mental illness. CONCLUSION: Persons with 22q11DS are likely to be medically complex patients with pervasive developmental disorders and late appearing mental problems. PRACTICE IMPLICATIONS: Establishing this diagnosis is useful to families and healthcare providers to anticipate and address immediate and future issues surrounding health promotion, disease prevention, and health maintenance.

Preconception health status of Iraqi women after trade embargo.

OBJECTIVES: To describe the preconception health status of Iraqi women in 2001 following the trade embargo imposed on Iraq beginning in 1991 and only partially removed in 1996. DESIGN: A descriptive cross-sectional prevalence study. SAMPLE: 500 Iraqi women at a premarital clinic in Baghdad in 2001. MEASUREMENTS: Women were surveyed for age, area of residence, menstrual history, household crowding, consanguinity, and a family history of congenital problems. Clinical findings regarding height, weight, and hemoglobin level were included in the data. RESULTS: Almost one third of the women were below the age of 20 and the majority were between 20 and 25 years of age. More than half of the women in this study had an intermediate-level education or less and lived in very crowded housing. Most of the women were anemic and reported a delay in menarche, suggesting malnutrition. Most of the women were planning consanguineous unions even though many reported congenital conditions in their family of origin. CONCLUSIONS: Young Iraqi women who endured embargo needed, and continue to need, aggressive preventive health services to recoup health gains lost during the 1990s and to address prevention of common congenital disorders.

Daytime sleepiness, exercise, and physical function in older adults.

The purpose of this study was to describe the association between sleepiness, exercise, and physical function in older adults, testing the hypothesis that sleepiness predicts decreased exercise and impaired physical function in this population. We performed a secondary analysis of data from the National Sleep Foundation's Sleep in America Poll, comparing frequency of exercise and ability to perform functional tasks between sleepy and non-sleepy subjects. Trained interviewers administered a scripted telephone survey. Participants (n = 1506) were community-dwelling older Americans (55-84 years) randomly chosen from geographically representative households with listed telephone numbers. Sleepiness 'so severe that it interferes with daytime activity' was dichotomized as 'daily/frequently' or 'never/rare'. Exercise frequency was scored 1-4 ('less than once a week' to 'more than five times a week'). Responses to five questions (walk 0.5 mile, climb stairs, push/pull heavy object, stoop/crouch/or kneel, write, handle small objects), rated 1-5 ('no difficulty' to 'unable to do'), were summed; a mean score of > or = 2.5 was considered impaired physical function. Daytime sleepiness predicted low exercise frequency while controlling for age and body mass index (BMI) (OR = 1.40, 95% CI 1.031-1.897, P = 0.031). Frequent daytime sleepiness predicted impaired physical function (OR = 2.76, 95%CI = 0.237-0.553, P = 0.001) after controlling for age, BMI, income and number of co-morbid conditions. The conclusion was that daytime sleepiness in older adults is associated with physical functional impairments and decreased exercise frequency. The findings suggest that sleepiness in older adults is not benign but has implications for continued physical decline and warrants attention.

The ecology of bipolar disorder: the importance of sleep.

Although much of the emphasis in treating Bipolar Disorder patients is on pharmacotherapy, sleep loss is an important trigger for mania and plays an important role in the condition. The purpose of this paper is to fully explore the chronobiological, environmental, social, and genetic factors that contribute to the sleep disruption that is characteristic of mania and bipolar disorder. This review is important because sleep, chronobiology, and genetics are under-emphasized content areas in nursing education. As a result, many practicing nurses are unaware of the importance of sleep for mental health or what to teach patients to improve both the quality of their sleep and the management of their condition.

Obstructive sleep apnea, nocturia and polyuria in older adults.

STUDY OBJECTIVE: The purpose of this study was to examine the relationship between nocturia and obstructive sleep apnea (OSA) in community dwelling older men and women. DESIGN: A repeated measures design was employed over a 24-hour period. SETTING: The study was conducted in a clinical research center. PARTICIPANTS: Thirty community-dwelling elders (mean age=65.5, SD=8.4 years) with symptoms of nocturia and sleep disordered breathing, volunteered to participate. Both men (n = 13) and women (n = 17) and minority subjects (African-Americans, n = 19; Caucasian, n = 11) were included in the study. INTERVENTIONS: NA. MEASUREMENTS: Blood specimens were collected every 4 hours, except for an 8-hour collection period overnight. Urine specimens were collected ad libitum and at the end of each data collection interval. Urine and blood specimens were analyzed for ANP and AVP content. Polysomnography was conducted using a full 18-channel montage. Apnea was defined as a decrease in airflow of > or = 90% for a minimum of 10 seconds. Hypopnea was defined as > or = 30% decrease in airflow and desaturations required a > or = 3% decrease in oxygen saturation for a minimum of 10 seconds. The apnea hypopnea index (AHI) was calculated as the sum of apneas and hypopneas divided by hours of sleep. RESULTS: Twenty of the thirty subjects were found to have clinically diagnosable OSA (AHI > or = 5). AVP excretion was not correlated with changes in AHI levels. Conversely, total urine output, plasma ANP and urine ANP excretion were significantly higher among subjects with higher AHI levels (> 15). CONCLUSION: In subjects with elevated AHI (> 15), nighttime urine production and ANP excretion are elevated.

Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis.

Although nocturnal voiding is frequently attributed to urologic disorders, nocturia and enuresis are also important symptoms of sleep-disordered breathing. However, polyuria can be elicited by obstructive sleep apnea as well as bedrest, microgravity and other experimental conditions where the blood volume is shifted centrally to the upper body. The nocturnal polyuria of sleep apnea is an evoked response to conditions of negative intrathoracic pressure due to inspiratory effort posed against a closed airway. The mechanism for this natriuretic response is the release of atrial natriuretic peptide due to cardiac distension caused by the negative pressure environment. This cardiac hormone increases sodium and water excretion and also inhibits other hormone systems that regulate fluid volume, vasopressin and the rennin-angiotensin-aldosterone complex. Treatment of sleep apnea and airway compromise has been shown to reverse nocturnal polyuria and thereby reduce or eliminate nocturia and enuresis. Thus, careful evaluation of nocturia and enuresis for evidence of nocturnal polyuria can increase the diagnostic certainty of referring primary care providers and sleep specialists. In addition, the resolution of these bothersome symptoms after treatment can contribute to patient satisfaction as well as reinforce treatment compliance.

Insulin resistance and obstructive sleep apnea: is increased sympathetic stimulation the link?

The science of sleep is in early stages of development, and the biochemical consequences of obstructive sleep apnea (OSA) are slowly being identified. Only recently have investigators begun to identify the commonalities and interaction between OSA and insulin resistance, the underlying pathology of type 2 diabetes. Obesity and increasing age play important parts in the natural history of both conditions, which frequently coexist. The purpose of this article is, first, to examine the extent and strength of studies that have investigated the association between OSA and increased insulin resistance or type 2 diabetes and, second, to propose a model that explains the association and cyclical interaction between OSA, obesity, and insulin resistance.

Bedwetting--not always what it seems: a sign of sleep-disordered breathing in children.

ISSUES AND PURPOSE: Nocturnal enuresis (bedwetting) can linger long into childhood. Sleep research has documented that nocturia and bedwetting are symptoms of obstructive sleep apnea (OSA) in adults and that bedwetting is predictive of OSA in children. CONCLUSIONS: Nocturnal polyuria is a cardiovascular response to negative pressure breathing (inspiration against a closed glottis), which is characteristic of OSA. PRACTICE IMPLICATIONS: Evidence of nocturnal polyuria and sleep-disordered breathing are important signs of OSA, a serious but treatable condition.